1. Field of Invention
This invention relates to long bone splints, specifically to an improved upper and lower extremity long bone splint that provides rigid long-axis immobilization with integrated balanced traction and off-axis stabilization capability.
2. Prior Art
Our military tactical combat care medics are encountering massive bony and soft-tissue injury from explosive IED and high-energy GSW to pelvis and lower extremities from an enemy who has effectively learned to inflict wounds below body armor. This invention is specifically designed to meet the needs of our military tactical combat care medics for a compact, lightweight, rapidly applied multi-purpose, multi-functional emergency quick splint that can effectively deliver rigid immobilization to both upper and lower extremity long bones, integrate dynamic balanced traction and off-axis stabilization when indicated by casualty presentation, and contain bony and associated massive soft-tissue injury from high-energy GSW, explosive IED trauma and low-energy crush injuries with one easy to use splint, that can be used effectively in combat, terrorist and WMD hot zones.
Today's tactical combat care medic typically does not carry commercial rigid long bone splints due to size and bulk. Long bone splints are usually improvised in the field by combining multiple formable splints in an attempt to achieve necessary length, strength and support for effective long bone immobilization. These formable splints were originally developed by Scheinberg, U.S. Pat. No. 6,991,612 for use on hands, wrists, forearms, and ankles. These formable splints have a malleable metal core that is covered by a layer of synthetic foam padding material on each of its opposite sides, and stow flat or rolled. This type of formable splint as a stand alone long bone immobilization device, lacks required long axis rigidity, length and width required to effectively manage massive bony and soft-tissue trauma experienced by today's hot zone casualties, but are excellent splints when used as originally designed to immobilize distal extremity trauma.
Collapsible single pole traction splints carried by tactical combat care medics were originally developed by Kendrick, U.S. Pat. No. 4,708,131. These collapsible single pole traction splints are applied laterally to a lower extremity. This type of traction splint requires a manual in-line distal tractive force be applied to an ankle harness (a pulling force on an ankle harness), with counter-traction force derived from a narrow webbing sling type strap looped around the medial groin soft-tissue to make the splint work. The force of the ankle harness pulling on the looped strap at the groin is contraindicated when associated with pelvic and hip trauma, limiting tactical effectiveness and use when pelvic and/or hip trauma may have occurred. This contraindication also prohibits use on upper extremities, as applied counter-traction force against limb root (about the shoulder and armpit) would occlude major blood vessels and compress the brachial plexus, possibly causing corollary trauma.
One aspect of the invention provides an in-line biomechanical traction force that maintains counter-traction force to the proximal end of the splint itself, not on the injured patient's limb root anatomy. The entire splint surface area in contact with the injured extremity anatomy functions as a counter-traction anchor. Applied biomechanical forces are thus dissipated and balanced throughout the whole splint, eliminating externally applied pressure against the limb root, eliminating possible contraindications.
When traction is applied to the ankle harness of an injured extremity using the collapsible single pole of the prior art, the force from the ankle harness exerts pressure on the web strap near the limb root, pulling the strap down toward the ankle harness. The counter traction force causes the unsupported collapsible single pole to bow laterally away from injured extremity. Mid-pole lateral deviation is significant, comparable to a long bow shaft when a taught string is applied to the extremities. To reduce this deviation, wide elastic bands are applied to hold the collapsible single pole to the injured extremity. The wide elastic bands bowing of the pole at the expense of using the injured leg to hold the pole in place. This known collapsible single pole structural deficiency is thought to be corrected, as documented in application instructions, by simply applying wide elastic band at knee prior to traction application, which is in effect using the injured extremity to splint the splint.
A preferred embodiment of this invention uses integrated dynamic quantified traction only to counter the natural tendency of the muscle to pull the distal bone end toward the injury, not for splint structure or to immobilize injured extremity as a whole. An anatomically shaped framesheet (10) includes a pocket (16) configured to be span the length of the underside of the injured leg and to receive a collapsible rigid tube (104). The tube (104) is used to provide rigidity to the splint and provides a site to attach a traction bar (110). A plurality of orbital dynamic closure straps (106) transforms framesheet (10) into a custom fitting posterior enveloping support platform. The support on the posterior of the injured extremity overcomes gravity effects on the injured extremity and provides an anchor point to which counter-traction forces may be applied. The posterior support wrapped around the injured extremity achieves realignment of soft tissue and bony structures along their original lines, while simultaneously containing massive soft-tissue trauma, tamponade hemorrhage and preventing aggravating movement.
Further, this invention stands in sharp contrast to prior art originally developed by Marble, U.S. Pat. No. 5,718,669 that provides integrated rigid, pneumatic, formable vacuum and traction means of immobilization. The integrated splint of the prior art requires multiple sizes to treat both upper and lower extremities, and is too bulky in cubic storage inches to be carried by military tactical combat care medics in hot zones. Most importantly, in a desert combat theater the polystyrene beads used for off-axis structure in the '669 patent during vacuum application retain environmental ambient heat and are subject to direct sunlight thermal heat retention. The heat retention properties of the polystyrene beads makes application, exposure and storage of the splint a challenge. WMD environments require splint removal, decontamination and reapplication in a warm zone, a process that cannot be performed with the polystyrene bead structure of the '669 patent. Additionally, any integrated traction in the prior art is not quantifiable lending to improper application in use in the field.
A preferred embodiment of this invention utilizes an integrated traction bar (110) with a dynamic quantifiable cantilever arm (30) to apply and quantify applied traction. Prior art traction splints generally need to apply 10% of the injured person's body weight up to a maximum of 15 pounds in traction just to make the splint work. This invention provides injury immobilization through the custom fitted posterior support wrapped around the leg and only uses integrated dynamic traction to balance contractive muscle pull and stabilize distal bone end retraction, rarely exceeding 5 pounds of applied traction.